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Cyclophosphamide (Endoxana)

Other names: Revimmune

Cyclophosphamide is a potent immunosuppressive drug that is frequently used in combination chemotherapy regimens to treat leukaemia and other forms of cancer.

Historically, cyclophosphamide has been used as a treatment for people with MS who have failed to respond to other therapies and are experiencing frequent relapses with rapid progression. Research has shown only limited benefit at best from the treatment, and the side effects mean that it is rarely used.

Side effects and contraindications

Cyclophosphamide research

PROMESS trial

A French study compared tretament with cyclophosphamide with IV methylpredisolone in people with secondary progressive MS. The study was ended early due to difficulty recruiting participants. Those people who stuck with cyclophosphamide over two years were 2.7 times less likely to show disability progression than the group taking the IV steroid. However, half of those taking cyclophosphamide and a third of those taking methylprednisolone dropped out, mostly due to tolerability issues. If data from all participants was included, the trial showed no difference between treatments.

Revimmune

Revimmune is the brand name of a new application of cyclophosphamide administered as an ultra-high intensity, short-course intravenous infusion.

Revimmune works by eliminating the cells responsible for the immune attack that is seen in multiple sclerosis, thereby allowing the body's immune system to 'reboot'.

Revimmune is in development for a variety of autoimmune diseases, and preliminary findings suggest it holds potential as a treatment option for people with severe refractory MS - MS that is not responding to other treatments. However, further studies are necessary to determine who would most benefit from this treatment.